Michael Sharpe skewered by @JohntheJack on Twitter

".. interventions were built upon a behavioural/deconditioning model of CFS."

I agree that "model" is probably a misnomer, and as @Robert 1973 points out, a lot of the slipperiness is around the imprecise use of language. But I would think just "model" or "framework" as a shorthand term in informal public discourse is nonetheless preferable to "theory" or "theoretical framework". Inclusion of a modifier clarifying substance and precisely synonymous with "hypothetical" would be preferable, but I'm afraid I'm unable to offer a decent candidate.

 

As Adrian said

Perhaps he's currently sitting in a life boat hanging from the side of the ship with a supply of beer/wine/tea/coffee just for himself. (but it's bring your own lifeboat, as MS is finding out)

 

One needs to distinguish between a clinical trial and treatment in clinical practice. I might be willing to subject myself to a treatment which I believe is ineffective and potentially harmful in a clinical trial if I felt it would help to advance the understanding of my condition. But I would not choose to try such a treatment in other circumstances.

In order for someone with a phobia to seek psychological treatment they presumably must first acknowledge that their fear is (or at least could be) irrational. Is there any evidence of people with phobias who refuse to accept the irrationality of their fear (even if they are unable to overcome it)? If someone were unable to acknowledge the irrationality of their phobia, might another diagnosis be appropriate?

 

Very badly!

 

https://twitter.com/user/status/1008709029370171393

 

Well that's a refreshingly straightforward answer.

 

https://twitter.com/user/status/1008683762367041537


https://twitter.com/user/status/1008687385587089409


https://twitter.com/user/status/1008689706731745287


https://twitter.com/user/status/1008708597633765376

 

How long before he torpedoes the ship?

 

I don't think we are in fear of exercise, it's not the right word to use.

Fear involves a physiological response to a threat. With ME we avoid overexerting ourselves for rational reasons as Trish said, because we know it will have a deleterious affect, there is no physiological experience involved.

It is the BPS brigade who push the notion of fear avoidance, but we're not in fear, and I don't think we should use the F word, it is playing into their agenda of fear avoidance, it is rational avoidance with no physiological correlate.


"The unpleasant emotional state consisting of psychological and psychophysiological responses to a real external threat or danger. ... Fear is a nursing diagnosis accepted by the North American Nursing Diagnosis Association, who defined it as a response to a perceived threat that is consciously recognized as a danger."
Fear | definition of fear by Medical dictionary
https://medical-dictionary.thefreedictionary.com/fear



Abstract
Anxiety is a psychological, physiological, and behavioral state induced in animals and humans by a threat to well-being or survival, either actual or potential. It is characterized by increased arousal, expectancy, autonomic and neuroendocrine activation, and specific behavior patterns. The function of these changes is to facilitate coping with an adverse or unexpected situation.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181681/

 

https://twitter.com/user/status/1008413427231084544

https://twitter.com/user/status/1008658229616939009

https://twitter.com/user/status/1008671826787164161

https://twitter.com/user/status/1008680059702595585

 

Say what!!!!!

 

But no explanation for his claim about the need for 'additional occupational support' here:

https://twitter.com/user/status/1005748795261554689


Also, there's been a failure to update this document since PACE showed CBT and GET failed to improve employment levels, so there's still a promotion of the notion that CBT/GET do aid return to work: "Occupational Aspects of the Management of Chronic Fatigue Syndrome: a National Guideline"?

https://www.nhshealthatwork.co.uk/images/library/files/Clinical excellence/CFS_full_guideline.pdf

 

Where exactly does he stand on this?

I'm getting a very confusing picture here:

https://twitter.com/user/status/884445916396228608


Then in 2015:
Linking benefits to treatment is unethical, and probably illegal
https://www.theguardian.com/comment...-people-mental-health-problems-work-treatment

How very Vicar of Bray!

 

It was well worth turning the world cup off for this its is like watching 1970s Brazil versus the Chuckle Brothers.

https://www.youtube.com/watch?v=M5HbmeNKino

https://www.youtube.com/watch?v=Ok8cpI3FdIY

 

He is confusing PIP (a UK benefit to help cope with disability when one needs lots of care and has mobility problems - and which can be an in-work benefit) with ESA (which is an out of work due to ill health benefit... meant to replace some of the lost income, it is pitifully little). If someone doesn't understand basics of the UK benefits system, how can they make pronouncements on their research relating to it?

 

This from the Contributors section of White et al 2011:
"The centre leaders were BA, TC, Eleanor Feldman, GM, MM, HO, Tim Peto, MS, PDW, DW, and Simon Wessely."

He is also listed as one of the SMC doctors.

He clearly has a very poor memory.

 

My reading is that he being subtly and elegantly diplomatic here. The man has some serious class.

 

https://twitter.com/user/status/1008614225164554240

https://twitter.com/user/status/1008722131171999744

 

https://twitter.com/user/status/1008722535477850112

https://twitter.com/user/status/1008731852142710785

https://twitter.com/user/status/1008737172462231552


I am tempted to ask if MS has actually read the paper.

 

LOL.